Table 1 Well-documented shortcomings of public involvement and their possible negative effects in the health and social care field. In grey, the factors/outcomes revealed by the analysis of co-production processes

Citizens

Team (Citizens and Researchers/Providers)

Citizens

Lack of competences [15, 20, 22,23,24,25]

Conflicts [22, 26]

Damage to ethics obligations [27]

Lack of trust [26, 28,29,30]

Different culture [26, 28, 29]

Lack of training of citizens [21, 27, 31,32,33]

Different opinions and strong personalities [34]

Damage relationship [35]

Lack of citizens’ motivation [24, 31]

Lack of feedback exchange [34]

Additional burden on citizens [1]

Lack of healthy and cognitive condition [1]

Lack of attention to individual needs [21]

Fatigue to participate [1]

Being frail/with severe illness [1]

Tokenism [22]

Citizens felt compelled and disempowered [22]

Lack (or perceived) of power [1, 22, 23, 28, 34,35,36]

Usage of technical language [22]

Increasing inequalities [24]

Lack of citizens’ financial compensation [21, 37]

Low citizens’ satisfaction toward results [24]

Citizens speaking different languages [25]

Low citizens’ awareness [24]

Researchers/Providers

Researchers/Providers

Lack of skilled facilitator [35]

Damage research careers [35]

Lack of motivation [1, 15, 31]

Damage research credibility [35]

Lack of competences [35, 36]

Damage relationship [35]

Perceived lack of citizens’ competences [1]

Misrepresent findings [27]

Additional fatigue [38]

System

System

System

Lack of resources [1, 27]

Misuse of resources [15]

Overuse/underuse of resources [15]

Lack of time [25, 29, 37]

Lack of transparency [21, 23, 34]

Damage interpersonal relationship [27]

Lack of funding [34]

Unreliable and unsatisfied results [24]

Complexity of the network [20]

Additional costs & effort [24]

Initiatives’ project related [1, 26]

Lack of inclusion of marginalized citizens [35, 39]

Does not clarify expectations [1, 21, 36]

Does not clarify roles [1, 22]

Does not clarify purpose of involvement [22]

Mobility issues [20, 21, 28, 30, 35, 39]